Test Code MTHX Methotrexate, Serum
Reporting Name
Methotrexate, SPerforming Laboratory
Mayo Clinic Laboratories in RochesterUseful For
Determining whether methotrexate is being cleared appropriately and verifying that a nontoxic concentration has been attained following therapy
Method Name
Immunoassay
Ordering Guidance
For patients that have received glucarpidase (carboxypeptidase G2) as a high-dose methotrexate rescue therapy, order MTXSG / Methotrexate Post Glucarpidase, Serum.
Shipping Instructions
Ship specimen in amber vial to protect from light.
Specimen Required
Supplies: Sarstedt 5 mL Aliquot Tube (Amber) (T915)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Amber vial
Specimen Volume: 0.5 mL
Collection Instructions:
1. Methotrexate is sensitive to fluorescent light; avoid prolonged exposure of specimen to direct light.
2. Serum gel tubes should be centrifuged within 2 hours of collection. Protect from light.
3. Red-top tubes should be centrifuged and serum aliquoted into amber vial within 2 hours of collection.
Specimen Type
SerumSpecimen Minimum Volume
0.25 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 14 days | LIGHT PROTECTED |
Frozen | 28 days | LIGHT PROTECTED | |
Ambient | 72 hours | LIGHT PROTECTED |
Reject Due To
Gross hemolysis | Reject |
Reference Values
Nontoxic drug concentration after 72 hours: <0.1 mcmol/L
Interpretation
Serum concentrations of methotrexate are commonly monitored during high-dose therapy (>50 mg/m[2]) to identify the time at which active intervention by leucovorin rescue should be initiated. Criteria for serum concentrations indicative of a potential for toxicity after single-bolus, high-dose therapy are as follows:
-Methotrexate >10 mcmol/L 24 hours after dose
-Methotrexate >1 mcmol/L 48 hours after dose
-Methotrexate >0.1 mcmol/L 72 hours after dose
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 dayTest Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
80204
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
MTHX | Methotrexate, S | 14836-1 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
MTHX | Methotrexate, S | 14836-1 |
Forms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.